卵巢癌化疗新进展Thestateoftheartinchemotherapyforovariancancers卵巢癌化疗新进展Thestateoftheartinchemotherapyforovariancancers复旦大学附属肿瘤医院妇瘤科第一页，共九十三页。女性生殖道肿瘤:全世界统计11.Ferlayetal.GLOBOCAN2000IARC,WHO2001(dep.iarc.fr)第二页，共九十三页。第三页，共九十三页。Women发病率32%Breast12%Lung&bronchus11%Colon&rectum6%Uterinecorpus4%Ovary4%Non-Hodgkinlymphoma3%Melanomaofskin3%Thyroid2%Pancreas2%Urinarybladder20%AllOtherSites死亡率25%Lung&bronchus15%Breast11%Colon&rectum6%Pancreas5%Ovary4%Non-Hodgkinlymphoma4%Leukemia3%Uterinecorpus2%Brain/ONS2%Multiplemyeloma23%AllothersitesCancerFacts&Figures,ACSO,2003第四页，共九十三页。IncidencesofGynecologicalCancersinShanghaiCitizens(1974-2000)4.86.510.511.226.72.54.44.82.54.49.16.30510152025301974199419972000YearIncidences(/100,000)OvarianCancerCervicalCacnerEndometrialCancer上海市居民卵巢癌、宫颈癌、宫体癌发病率〔1974-2000，SCDC〕第五页，共九十三页。内容简介1.早期卵巢癌化疗2.中晚期卵巢癌化疗3.新辅助化疗/中间手术4.复发性卵巢癌化疗5.维持\稳固治疗6.Ca125升高处理第六页，共九十三页。卵巢癌的治疗未治患者主要目的是治愈手术分期和细胞减灭术，继而紫杉醇/铂类联合化疗复发患者主要目的是减轻病症和提高生活质量化疗可以延长生存时间最终结果长期存活:25-30%5-年生存率从30%(1970s)提高至>50%RiesLAGetal.SEERCancerStatisticsReview,1975-2001,NationalCancerInstitute.Bethesda,MD,://seer.cancer.gov/csr/1975;2001/,2004.卵巢癌可认为是一种慢性疾病第七页，共九十三页。早期卵巢癌:FIGOIandII全面的分期剖腹探查术经腹全子宫/双侧卵巢输卵管切除(TAH/BSO)大网膜切除淋巴结切除术〔dissection〕腹膜和膈膜活检〔biopsies〕细胞学检查高危vs低危早期卵巢癌Stagingclassificationsandclinicalpracticeguidelinesofgynaecologiccancers.figo.org第八页，共九十三页。早期卵巢癌MedicalOncology:Acomprehensivereview.cancernetworktextbook低危高危(5–10%复发率)(30–40%复发率)StageIAorIBStageICGrade1(or2)Grade3Clearcellcancer第九页，共九十三页。高危早期卵巢癌1.YoungSGO20032.YoungRC.SeminOncol27(3):8-10.,20002.3.ICON-1,EORTC-ACTION:JNatnlCanIn...
